Open AccessEffect of periodontal treatment on glycemic control of patients with diabetes: A systematic review and meta‐analysis
Author(s) -
Corbella Stefano,
Francetti Luca,
Taschieri Silvio,
Siena Francesca,
Fabbro Massimo Del
Publication year - 2013
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12088
Subject(s) - medicine , glycemic , confidence interval , meta analysis , glycated hemoglobin , randomized controlled trial , diabetes mellitus , adjunctive treatment , gastroenterology , type 2 diabetes , endocrinology , insulin
Aims/Introduction The aim of the present study was to investigate whether non‐surgical periodontal treatment reduces glycated hemoglobin ( H b A 1c ) and fasting plasma glucose ( FPG ) levels in diabetic patients. Materials and Methods An electronic search was carried out on MEDLINE (through P ub M ed interface), EMBASE and the C ochrane C entral R egister of C ontrolled T rials. Randomized controlled trials with a minimum of 3 months follow up were included. The risk of bias was assessed for each study. A meta‐analysis was carried out to evaluate the effect of non‐surgical periodontal treatment on H b A 1c and FPG levels. The effect of the adjunctive use of antimicrobials was also assessed. Results A total of 15 studies were included. A reduction of −0.38% (95% confidence interval [CI] −0.23 to −0.53) after 3–4 months ( P < 0.001) and of −0.31% (95% CI 0.11 to −0.74) after 6 months ( P = 0.15) of follow‐up was found for H b A 1c , favoring the treatment group. Similarly, in treated patients, a significantly greater decrease in FPG was observed in respect to control participants. Such difference amounted to −9.01 mg/dL (95% CI −2.24 to −15.78) after 3–4 months ( P = 0.009) and −13.62 mg/dL (95% CI 0.45 to −27.69) after 6 months ( P = 0.06) from treatment, respectively. In participants treated with adjunctive antimicrobials, a non‐significant increase of H b A 1c was observed 3 months after treatment, whereas FPG decreased by 0.27 mg/dL (95% CI 39.56 to −40.11; P = 0.99). Conclusions The meta‐analysis showed that non‐surgical periodontal treatment improves metabolic control in patients with both periodontitis and diabetes.